Letters to the Editor NEUROLEPTIC MALIGNANT SYNDROME Sir, A 35 year male, indoor patient was referred by a physician for poor cooperation for diet, self care, impaired sleep, tightness of extremities and reduced mobility. Past history of vague fever and abnormal behaviour for which he changed different physicians and psychiatrists without improvement, reported treatment with antipsychotics, chl...

Neuroleptic malignant syndrome (NMS) is a potentially fatal adverse event associated with the use of antipsychotics (AP). The objective of this study was to investigate the profile of cases of NMS and to compare our findings with those published in similar settings. A series of 18 consecutive patients with an established diagnosis of NMS was analyzed, gathering data on demography, symptoms and ...

Neuroleptic Malignant Syndrome is both rare and potentially fatal. Health clinicians need to recognize signs and symptoms and ask the right questions to make an accurate diagnosis and begin treatment. While this condition is not entirely understood, its symptoms are recognizable and typically easily resolved with little or no long-term impact to the patient when caught early. A treatment and ma...

The neuroleptic malignant syndrome (NMS) is presumably caused by neuroleptic blockade of dopamine receptors, mainly in the basal ganglia and hypothalamus. Symptoms include hyperthermia, muscular rigidity, and elevated serum creatine phosphokinase level, also autonomic dysfunction and, facultatively, impairment of consciousness. Clinical features, differential diagnosis and pathogenesis are disc...

We report 37-year-old man admitted to the psychiatric ward with acute depression. Antidepressive medications were initiated including: promethazine hydrochloride, hydroxyzine hydrochloride, lorazepam and haloperidol. In an attempt to control his depression, doctors increased the dose of haloperidol. Five days later he developed fever, cough, confusion and he was unable to eat. Accordingly, he w...

G J. Chandran and associates, in their report of a case of neuroleptic malignant syndrome (NMS), describe an 81-year-old man who was given 2 dopamine D2 blocking agents, with a total daily dose roughly equivalent to 9 mg of haloperidol, a very high dosage for someone this age. Within 3 days, one of these drugs was stopped, but the dosage of the other was increased. Although we do not know exact...

Neuroleptic malignant syndrome is a rare but serious adverse effect of antipsychotic medication. The author describes three new cases and reviews 50 others published in the past 5 years. Demographic and clinical features, diagnosis, treatment, outcome, and pathophysiology are critically reviewed, and a new set of diagnostic criteria, incorporating physical signs and routine laboratory tests, is...

The paper defines neuroleptic malignant syndrome and analyses its incidence, predisposing factors, etiology, pathological anatomy and pathogenetic hypotheses. Symptomatology consists of three principal symptoms: extrapyramidal symptoms, hyperthermia, deregulation of the autonomic nervous system. The differential diagnosis of other similar conditions is outlined together with a proposal for a tr...

“Ms. A,” a 25-year-old woman with paranoid schizophrenia, presented with an acute psychotic episode after having stopped taking her medication. She reported auditory hallucinations and was noted to be disheveled and to have loud, pressured speech, disorganization of thought processes, and persecutory delusions. Over a 10-hour period in the emergency department, she received two intramuscular in...

Author Eelco FM Wijdicks, MD Section Editor Michael J Aminoff, MD, DSc Deputy Editor Janet L Wilterdink, MD The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website ...